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06-28-2018 | Dapagliflozin | ADA 2018 | News

DEPICT-2 confirms dapagliflozin efficacy in type 1 diabetes

medwireNews: The DEPICT-2 findings confirm those of DEPICT-1, with dapagliflozin producing improved glycemic control and weight loss, and reduced insulin need, in patients with type 1 diabetes.

However, in line with the 52-week results of DEPICT-1 and the inTandem1 trial, use of the sodium-glucose cotransporter (SGLT)2 inhibitor was associated with a slight but significant increase in diabetic ketoacidosis (DKA).

During 24 weeks of treatment with dapagliflozin, 2.6% of the 271 patients taking the 5 mg dose had DKA events, as did 2.2% of the 270 patients taking the 10 mg dose and none of the 272 taking placebo.

Nonetheless, patients also achieved significant 0.37% and 0.42% reductions in average glycated hemoglobin levels with the 5 and 10 mg doses, respectively, relative to placebo, and a corresponding 39.5% and 41.6% versus 20.1% achieved the secondary composite endpoint of an HbA1c reduction of at least 0.5% without severe hypoglycemia.

Patients taking dapagliflozin also had significant weight reductions versus placebo, of 3.40% and 3.74% with the 5 and 10 mg doses, respectively, and reduced their insulin requirements, by a corresponding 10.78% and 11.08%.

The study participants underwent continuous glucose monitoring at baseline and 24 weeks, revealing a 9–10% improvement versus the placebo group in the proportion of time patients spent within the blood glucose range of 70–180 mg/dL.

Chantal Mathieu (KU Leuven, Belgium), who presented the results to the press at the ADA’s 78th Scientific Sessions in Orlando, Florida, USA, said that time in range is a “very important parameter in my eyes as a clinician,” and stressed that the improvement seen with dapagliflozin “is in the same ballpark as what you can achieve with the almost closed-loop systems that we have at the moment.”

Discussing the DKA findings while presenting the results to conference attendees, co-researcher Paresh Dandona (State University of New York at Buffalo, USA) suggested that “we have to live with the fact” that SGLT2 inhibitors increase DKA risk in type 1 diabetes patients, stressing that this is an area “where we’ve been bereft of treatments” except those relating to new insulin formulations and delivery systems.

By Eleanor McDermid

medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group

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